在先天性心脏手术结果中的儿童机会,种族和语言
Kenneth M Coca1, Jamie L Fierstein2,3, Joseph Manipadam3
1Johns Hopkins All Children's Heart Institute, Johns Hopkins All Children's Hospital, 501 6th Avenue South Saint Petersburg, St. Petersburg, FL, 33701, USA. kenneth.coca@jhu.edu.
Pediatric cardiology
|January 22, 2026
概括
邻居机会对患有先天性心脏病的儿童的手术结果没有影响. 然而,种族和民族差异以及语言障碍与更糟糕的结果有关,这表明这些因素可能无法完全被社区机会指标所捕获.
科学领域:
- 儿科心脏手术 儿科心脏手术
- 健康 公平 卫生 公平
- 健康的社会决定因素
背景情况:
- 种族,民族和语言差异与社会经济因素相交,影响儿童的机会.
- 这些不平等可能会影响健康结果,特别是在脆弱人群中,如接受复杂医疗程序的儿童.
研究的目的:
- 评估手术结果与复合儿童邻居机会指数 (COI),种族/种族以及儿科先天性心脏手术中的语言障碍之间的关联.
- 确定邻居机会是否完全解释了手术结果中观察到的差异.
主要方法:
- 对1568名接受先天性心脏手术的儿科患者进行了回顾性队列研究 (2010-2023年).
- 患者按基于地址的复合社区机会指数 (COI) 的五分位数进行分类.
- 分析结果:住院死亡率,住院时间 (LOS),主要并发症. 使用通用线性混合模型进行的调整分析.
主要成果:
- 邻里机会指数 (COI) 与死亡率,LOS或并发症没有独立相关.
- 与非西班牙裔白人患者相比,非西班牙裔黑人患者的住院死亡率更高,LOS更长.
- 患有非英语护理人员的患者经历了更长时间的LOS.
结论:
- 综合社区机会指数 (COI) 并没有独立预测儿科先天性心脏手术中的外科结果.
- 根据种族/种族和护理人员的语言,死亡率和停留时间的显著差异仍然存在.
- 这些发现表明,COI可能不完全涵盖结构性种族主义或沟通障碍对儿科心脏手术结果的影响.
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